Amenorrhea – primary: Overview, Causes

Alternate Names : Primary amenorrhea, No periods, Absent periods, Absent menses


Amenorrhea is the absence of menstruation. Primary amenorrhea is not considered to have occurred until a girl is beyond age 16, if she has undergone other normal changes that occur during puberty.

See also:

* Menstruation – absent
* Secondary amenorrhea

Overview, Causes, & Risk Factors

Most girls begin menstruating between ages 9 and 18, with an average around 12 years old. Primary amenorrhea is not considered to have occurred until a girl is beyond age 16, if she has undergone other normal changes that occur during puberty. Primary amenorrhea may occur with or without other signs of puberty.

There are many possible causes of primary amenorrhea:

* Adrenogenital syndrome
* Chromosomal abnormalities such as Turner syndrome or Sawyer syndrome
* Congenital heart disease (cyanotic)
* Congenital adrenal hyperplasia
* Craniopharyngioma
* Chronic (long-term) illnesses
* Cushing’s disease
* Cystic fibrosis
* Extreme weight loss
* Genital abnormalities present since birth (absence of the uterus or vagina, vaginal septum, cervical stenosis, imperforate hymen)
* Gonadal dysgenesis
* Hypoglycemia
* Hypothyroidism and hyperthyroidism
* Hypogonadotropic hypogonadism
* Hyperprolactinemia
* Malnutrition
* Obesity
* Prader-Willi syndrome
* Pregnancy
* Polycystic ovarian disease
* Testicular feminization
* True hermaphroditism
* Tumors of the pituitary or adrenal glands
* Tumors of the ovaries

Pictures & Images

Primary amenorrhea

Primary amenorrhea is the absence of the menstrual period by the age of 16. Treatment of amenorrhea may range from hormonal supplementation for developmental abnormalities of the reproductive system to surgery for tumors of the pituitary.

Normal uterine anatomy (cut section)

Normal uterine anatomy (cut section)

The uterus is a muscular organ with thick walls, two upper openings to the fallopian tubes and an inferior opening to the vagina.

Amenorrhea – primary: Overview, Causes

Amenorrhea – primary: Symptoms & Signs, Diagnosis & Test

Amenorrhea – primary: Treatment

Review Date : 6/26/2008
Reviewed By : Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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